Noor H A Suaini1,2, Evelyn Xiu-Ling Loo2,3, Rachel L Peters1,4, Gaik Chin Yap3, Katrina J Allen1,4,5,6, Hugo Van Bever3,7, David J Martino1,4,8, Anne Eng Neo Goh9, Shyamali C Dharmage10, Marjorelee T Colega2, Mary Foong Fong Chong2,11, Anne-Louise Ponsonby10,12, Kok Hian Tan13, Mimi L K Tang1,4,5, Keith M Godfrey14,15, Bee Wah Lee3, Lynette Pei-Chi Shek2,3,7, Jennifer J Koplin1,4,10, Elizabeth Huiwen Tham2,3,7. 1. Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Vic, Australia. 2. Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore City, Singapore. 3. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore. 4. Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia. 5. Department of Allergy and Clinical Immunology, Royal Children's Hospital, Parkville, Vic, Australia. 6. Institute of Inflammation and Repair, University of Manchester, Manchester, UK. 7. Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore City, Singapore. 8. Telethon Kids Institute, University of Western Australia, Perth, Australia. 9. Allergy Service, Department of Paediatrics, KK Women's and Children's Hospital (KKH), Singapore City, Singapore. 10. The School of Population and Global Health, University of Melbourne, Carlton, Vic, Australia. 11. Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore. 12. Neuroepidemiology Research Group, Florey Institute for Neuroscience and Mental Health, Parkville, Australia. 13. Department of Maternal Fetal Medicine, KK Women's and Children's Hospital (KKH), Singapore City, Singapore. 14. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. 15. Medical Research Council Lifecourse Epidemiology Unit, Southampton, UK.
Abstract
BACKGROUND: In Western countries, Asian children have higher food allergy risk than Caucasian children. The early-life environmental exposures for this discrepancy are unclear. We aimed to compare prevalence of food allergy and associated risk factors between Asian children in Singapore and Australia. METHODS: We studied children in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n = 878) and children of Asian ancestry in the HealthNuts cohort (n = 314). Food allergy was defined as a positive SPT ≥3 mm to egg or peanut AND either a convincing history of IgE-mediated reaction at 18 months (GUSTO) or a positive oral food challenge at 14-18 months (HealthNuts). Eczema was defined as parent-reported doctor diagnosis. RESULTS: Food allergy prevalence was 1.1% in Singapore and 15.0% in Australia (P<0.001). Egg introduction was more often delayed (>10 months) in Singapore (63.5%) than Australia (16.3%; P<0.001). Prevalence of early-onset eczema (<6 months) was lower in Singapore (8.4%) than Australia (30.5%) (P<0.001). Children with early-onset eczema were more likely to have food allergy than those without eczema in Australia [aOR 5.11 (2.34-11.14); P<0.001] and Singapore [aOR4.00 (0.62-25.8); P = 0.145]. CONCLUSIONS: Among Asian children, prevalence of early-onset eczema and food allergy was higher in Australia than Singapore. Further research with larger sample sizes and harmonized definitions of food allergy between cohorts is required to confirm and extend these findings. Research on environmental factors influencing eczema onset in Australia and Singapore may aid understanding of food allergy pathogenesis in different parts of the world.
BACKGROUND: In Western countries, Asian children have higher food allergy risk than Caucasian children. The early-life environmental exposures for this discrepancy are unclear. We aimed to compare prevalence of food allergy and associated risk factors between Asian children in Singapore and Australia. METHODS: We studied children in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n = 878) and children of Asian ancestry in the HealthNuts cohort (n = 314). Food allergy was defined as a positive SPT ≥3 mm to egg or peanut AND either a convincing history of IgE-mediated reaction at 18 months (GUSTO) or a positive oral food challenge at 14-18 months (HealthNuts). Eczema was defined as parent-reported doctor diagnosis. RESULTS: Food allergy prevalence was 1.1% in Singapore and 15.0% in Australia (P<0.001). Egg introduction was more often delayed (>10 months) in Singapore (63.5%) than Australia (16.3%; P<0.001). Prevalence of early-onset eczema (<6 months) was lower in Singapore (8.4%) than Australia (30.5%) (P<0.001). Children with early-onset eczema were more likely to have food allergy than those without eczema in Australia [aOR 5.11 (2.34-11.14); P<0.001] and Singapore [aOR4.00 (0.62-25.8); P = 0.145]. CONCLUSIONS: Among Asian children, prevalence of early-onset eczema and food allergy was higher in Australia than Singapore. Further research with larger sample sizes and harmonized definitions of food allergy between cohorts is required to confirm and extend these findings. Research on environmental factors influencing eczema onset in Australia and Singapore may aid understanding of food allergy pathogenesis in different parts of the world.
Authors: Victoria X Soriano; Rachel L Peters; Margarita Moreno-Betancur; Anne-Louise Ponsonby; Grace Gell; Alexsandria Odoi; Kirsten P Perrett; Mimi L K Tang; Lyle C Gurrin; Katrina J Allen; Shyamali C Dharmage; Jennifer J Koplin Journal: JAMA Date: 2022-07-05 Impact factor: 157.335